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Not all coverage is the right coverage.

The healthcare coverage you need is probably very different than the coverage some of your co-workers need. Age, family status, medical conditions, hobbies, lifestyle and a myriad of other factors will help you determine if you need a lot or a very little amount of health coverage. That’s why HealthEZ provides multiple coverage options, so you’re never caught paying too much money, or worse, having too little coverage.

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Summary Of Medical Benefits

HSA Plan 2

In-Network

Out-Of-Network

Calendar Year Deductible

Individual

Family

 

$5,000

$10,000

 

$10,000

$20,000

Out-Of-Pocket Maximum

Individual

Family

 

$6,500

$13,000

 

$13,000

$26,000

Preventive Care

No Charge

20% Coinsurance after Deductible

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

10% Coinsurance after Deductible

10% Coinsurance after Deductible

10% Coinsurance after Deductible

 

20% Coinsurance after Deductible

20% Coinsurance after Deductible

20% Coinsurance after Deductible

Hospital Services

10% Coinsurance after Deductible

20% Coinsurance after Deductible

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

10% Coinsurance after Deductible

10% Coinsurance after Deductible

 

20% Coinsurance after Deductible

20% Coinsurance after Deductible

Urgent Care Services

10% Coinsurance after Deductible

20% Coinsurance after Deductible

Teladoc Services

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, initial evaluation

Mental Health - Psychiatrist, ongoing session

 

10% Coinsurance after Deductible

10% Coinsurance after Deductible

10% Coinsurance after Deductible

10% Coinsurance after Deductible

10% Coinsurance after Deductible

 

10% Coinsurance after Deductible

10% Coinsurance after Deductible

10% Coinsurance after Deductible

10% Coinsurance after Deductible

10% Coinsurance after Deductible

Mental Health / Chemical Dependency

Inpatient

Outpatient

 

10% Coinsurance after Deductible

10% Coinsurance after Deductible

 

20% Coinsurance after Deductible

20% Coinsurance after Deductible

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

 

$10 Copay after Deductible

20% Coinsurance after Deductible

50% Coinsurance after Deductible

20% Coinsurance after Deductible

 

$20 Copay after Deductible

20% Coinsurance after Deductible

50% Coinsurance after Deductible

Not available

**Covered in-network if deemed true emergency

 

 


Summary of Medical Benefits

Copay Plan 1

In-Network

Out-of-Network

Calendar Year Deductible

Individual

Family

 

$3,000

$6,000

 

$6,000

$12,000

Out-of-Pocket Maximum

Individual

Family

 

$4,000

$8,000

 

$8,000

$16,000

Preventative Care

No Charge

50% Coinsurance After Deductible

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

$25 Copay

$50 Copay

$50 Copay

 

50% Coinsurance After Deductible

50% Coinsurance After Deductible

50% Coinsurance After Deductible

Urgent Care Services

$100 Copay

50% Coinsurance After Deductible

Hospital Services

Inpatient

Outpatient

 

20% Coinsurance After Deductible

20% Coinsurance After Deductible

 

50% Coinsurance After Deductible

50% Coinsurance After Deductible

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

$500 Copay

20% Coinsurance After Deductible

 

$500 Copay

50% Coinsurance After Deductible

Teladoc Services

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, initial evaluation

Mental Health - Psychiatrist, ongoing session

 

No Charge

No Charge

No Charge

No Charge

No Charge

 

No Charge

No Charge

No Charge

No Charge

No Charge

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

20% Coinsurance After Deductible

$50 Copay

 

50% Coinsurance After Deductible

50% Coinsurance After Deductible

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30-Day Supply

$10 Copay

$35 Copay

$75 Copay

$300 Copay

Mail Order 90-Day Supply

$20 Copay

$70 Copay

$150 Copay

Not available

**Covered in-network if deemed true emergency

 

 

HSA Plan 1

In-Network

Out-of-Network

Calendar Year Deductible

Individual

Family

 

$3,000

$6,000

 

$6,000

$12,000

Out-of-Pocket Maximum

Individual

Family

 

$4,000

$8,000

 

$8,000

$16,000

Preventative Care

No Charge

20% Coinsurance after Deductible

Office Visits

Primary Services

Specialist Services

Chiropractic Services

 

10% Coinsurance after Deductible

10% Coinsurance after Deductible

10% Coinsurance after Deductible

 

20% Coinsurance after Deductible

20% Coinsurance after Deductible

20% Coinsurance after Deductible

Hospital Services

10% Coinsurance after Deductible

20% Coinsurance after Deductible

Emergency Services**

Emergency Room

Emergency Medical Transportation

 

10% Coinsurance after Deductible

10% Coinsurance after Deductible

 

20% Coinsurance after Deductible

20% Coinsurance after Deductible

Urgent Care Services

10% Coinsurance after Deductible

20% Coinsurance after Deductible

Teladoc Services

General Consultations

Dermatology

Mental Health - Therapist

Mental Health - Psychiatrist, initial evaluation

Mental Health - Psychiatrist, ongoing session

 

10% Coinsurance after Deductible

10% Coinsurance after Deductible

10% Coinsurance after Deductible

10% Coinsurance after Deductible

10% Coinsurance after Deductible

 

10% Coinsurance after Deductible

10% Coinsurance after Deductible

10% Coinsurance after Deductible

10% Coinsurance after Deductible

10% Coinsurance after Deductible

Mental Health/Chemical Dependency

Inpatient

Outpatient

 

10% Coinsurance after Deductible

10% Coinsurance after Deductible

 

20% Coinsurance after Deductible

20% Coinsurance after Deductible

Prescription Drug Coverage

Generic

Preferred brand

Non-preferred brand

Specialty

Retail 30-Day Supply

$10 Copay after Deductible

20% Coinsurance after Deductible

50% Coinsurance after Deductible

20% Coinsurance after Deductible

Mail Order 90-Day Supply

$20 Copay after Deductible

20% Coinsurance after Deductible

50% Coinsurance after Deductible

Not available

**Covered in-network if deemed true emergency

 

 

If you prefer talking with a HealthEZ representative, call 844-302-7784